Clinica Terapeutica最新文献

{"title":"Diagnostic and Surgical Challenges of Cauda Equina Syndrome in Elderly Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis of Clinical, Radiological, and Surgical Outcomes.","authors":"Mohd Alhalki, Neveen Shalaby, Zenat Khired, Ahmed Adel Ayad, Mona Atef Alatar, Hatem Attia Mostafa Ismail, Neeveen Abdel Latif Fahmy Elshewy, Walaa Yusif, Tamer Hassan Rashwan, Ahmed Atef Ganna, Mariam Ghanem, Mohamed Hashem Youssef Abdou, Rasha Zaki, Mahmoud Kamel Elawady, Amr A Abdelkader","doi":"10.7417/CT.2026.2131","DOIUrl":"10.7417/CT.2026.2131","url":null,"abstract":"<p><strong>Background: </strong>Cauda equina syndrome (CES) is a rare but severe neurological emergency requiring urgent surgical decompression. In elderly patients with diabetes mellitus, overlapping neuropathic features may obscure classical CES presentation, leading to delayed diagnosis and worse outcomes.</p><p><strong>Objectives: </strong>To evaluate diagnostic challenges, surgical management, perioperative complications, and recovery outcomes in elderly diabetic patients with CES.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL was conducted for studies published between January 2015 and April 2026. Two independent reviewers performed study selection, data extraction, and risk of bias assessment. Random-effects meta-analyses were conducted, and heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Twenty-eight studies, published between 2016 and 2025 across 14 countries, comprised 1,427 elderly patients with diabetes mellitus and confirmed CES were analyzed. The pooled mean diagnostic delay was 4.8 days (95% CI: 3.9-5.7). Saddle anaesthesia was absent at presentation in 38.7% of patients. Surgical decompression within 48 hours significantly improved bladder recovery (OR: 2.74; 95% CI: 1.89-3.97; I²=38%). Each 1% increase in preoperative HbA1c was associated with a 4.3% reduction in neurological recovery (p=0.003). The pooled complication rate was 34.7% (95% CI: 29.1-40.3%), and 30-day mortality was 2.2%.</p><p><strong>Conclusions: </strong>Elderly diabetic patients with CES experience delayed diagnosis and increased perioperative risk. Early surgical decompression within 48 hours and optimal glycaemic control are key determinants of improved outcomes. Tailored diagnostic pathways for this population are warranted.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1299-1316"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico Legal aspects on Low-Grade Biofilm Infection to MDR Nosocomial Prosthetic Joint Infection.","authors":"Mauro Salducci, Maria Sofia Simonelli, Raimondo Raimondi","doi":"10.7417/CT.2026.2093","DOIUrl":"10.7417/CT.2026.2093","url":null,"abstract":"<p><strong>Abstract: </strong>Prosthetic joint infections (PJI) are among the most challenging complications of orthopedic surgery, particularly when involving both biofilm-forming low-virulence organisms and multidrug-resistant (MDR) pathogens. This report outlines the complex pathophysiology and clinical challenges associated with PJI, transitioning from a low-grade chronic infection to an acute MDR nosocomial infection, highlighting significant medicolegal implications.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"979-981"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivery Riders at the Crossroads of Occupational Health, Climate Change, and Algorithmic Management.","authors":"Francesca Antonia Ammirati, Salvatore Ammirati, Gioacchino Bruccoleri, Giuseppe La Torre, Giorgia Mantione","doi":"10.7417/CT.2026.2126","DOIUrl":"10.7417/CT.2026.2126","url":null,"abstract":"<p><strong>Abstract: </strong>Delivery riders have become a defining workforce of contemporary urban economies, yet existing occupational health frameworks remain poorly adapted to the realities of platform-mediated work. This editorial proposes a shift from static, factor-based models of risk toward a dynamic and cumulative perspective, and provides a comparative classification of regulatory approaches worldwide, highlighting how jurisdictions are addressing, or failing to address, the occupational risks of platform work. Riders operate at the intersection of three interacting domains: algorithmic management, environmental exposure, and climate-related stressors. Rather than acting as independent risk factors, these processes mutually reinforce one another, shaping exposure and behaviour in real time. Platform-driven time pressures influence riding practices within hazardous urban environments, while extreme weather and air pollution further affect psychophysiological performance. Within this framework, algorithmic management should be understood not merely as a mode of work organization but as a structural determinant of occupational health. By regulating task allocation, temporal constraints, and incentive structures, digital systems actively generate and redistribute risk. Occupational hazards are therefore not simply encountered by riders but dynamically produced through the interaction between technological control, environmental conditions, and urban infrastructures.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1238-1241"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Artificial Intelligence (AI) for Myocardial Infarction Health Information: Expert Accuracy Assessment and User Trust Survey.","authors":"Eman Elsheikh, Abdullah Ahmed Aladsani, Yousef Abdullatif Aljohar, Ghala Abdulaziz Alzahrani, Ali M Alsadah, Maryam Abdulmohsen Almuhaysh, Walah Sami Rashid Alowaynan, Rehab H Werida","doi":"10.7417/CT.2026.2124","DOIUrl":"10.7417/CT.2026.2124","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence chatbots, particularly ChatGPT, have emerged as increasingly popular sources of health information for the general public. However, concerns persist regarding the accuracy, safety, and appropriateness of AI-generated medical advice, especially for life-threatening conditions such as myocardial infarction.</p><p><strong>Objectives: </strong>This study aimed to evaluate the accuracy, completeness, and safety of ChatGPT-generated responses and information to public questions about heart attacks, assess user perceptions and trust, and compare AI-generated content with expert-validated sources.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between January and March 2026. A total of 73 commonly asked heart attack-related questions were submitted to ChatGPT (GPT-4), and responses were independently evaluated by two expert reviewers and one external reviewer using standardized rubric assessing accuracy, completeness, clarity, safety, and tone. Inter-rater reliability was assessed using intraclass correlation coefficients. In parallel, a survey of 352 participants evaluated user perceptions, trust, and behavioral use of ChatGPT for medical information. Statistical analyses included descriptive statistics, group comparisons, correlation analyses, and multivariable regression models to identify predictors of trust and satisfaction.</p><p><strong>Results: </strong>Expert reviewers assigned high ratings for accuracy (mean: 4.62 ± 0.62 and 4.48 ± 0.63) and safety (mean: 4.78 ± 0.51 and 4.05 ± 0.50), with substantial inter-rater agreement (ICC = 0.788). In contrast, the external reviewer documented considerably lower completeness ratings (2.59 ± 0.57), revealing deficiencies in information coverage. Remarkably, 40.6% of respondents indicated they had followed ChatGPT's medical recommendations without seeking professional consultation, while 17.6% reported depending on the chatbot during urgent medical situations. Levels of user trust and satisfaction were moderate, showing significant correlations with perceived accuracy, usage frequency, and healthcare-related educational background.</p><p><strong>Conclusions: </strong>Expert assessments confirmed that ChatGPT generally provides accurate and safe cardiovascular health information; nevertheless, considerable inter-reviewer variability-especially the markedly lower completeness scores from the external evaluator-reveals significant gaps in content depth. These results indicate that ChatGPT functions more appropriately as an adjunctive educational resource rather than a replacement for professional medical consultatio n, emphasizing the necessity for enhanced safety mechanisms, clearer user instructions, and standardized content protocols when addressing high-stakes health topics. ChatGPT should be considered an adjunctive resource rather than a substitute for urgent professional medical assessment in suspected heart attack cases.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1216-1233"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Induction Outcomes in Acute Myeloid Leukemia: Impact of Clinical Status, Infectious Complications, Cardiometabolic Comorbidities, and Diagnostic Features in a Cohort Study.","authors":"Ahmed Akef, Maysa Aly, Mohamed Hanafy Morsy, Ola Abd Elfattah Ali Amro, Fatma M Elsayed, Heba Yahia Elkholy, Murad Barakat, Loai Emam, Amira N Ahmed, Lama M El-Attar, Peter Makram Thabet Matta, Salwa M Abdelhamid, Walid Mohamed Kamel Ahmed, Eiman Ibrahim, Neveen Shalaby","doi":"10.7417/CT.2026.2113","DOIUrl":"10.7417/CT.2026.2113","url":null,"abstract":"<p><strong>Background: </strong>Induction chemotherapy outcomes in acute myeloid leukemia (AML) remain suboptimal in many low- and middle-income countries due to delayed diagnosis, limited supportive care resources, and treatment-related complications. Data regarding predictors of induction outcomes in resource-limited settings remain scarce. This study aimed to evaluate day-28 induction outcomes and identify clinical, laboratory, infectious, comorbidity-related, and diagnostic factors associated with unfavorable induction outcomes in adult AML patients.</p><p><strong>Methods: </strong>This observational cohort study included 90 adult patients with newly diagnosed non-acute promyelocytic leukemia (non-APL) AML who received induction chemotherapy between January 2020 and December 2024 at Al-Azhar University Hospitals, Cairo, Egypt. Day-28 induction outcomes were categorized as complete remission (CR), refractory disease (R), or induction-related death (IID). Unfavorable induction outcome was defined as refractory disease or IID. Baseline demographic, clinical, laboratory, infectious, comorbidity, immunophenotypic, and cytogenetic variables were analyzed using univariate and multivariate logistic regression models.</p><p><strong>Results: </strong>Among the 90 patients, 53 (58.9%) achieved CR, 20 (22.2%) had refractory disease, and 17 (18.9%) experienced IID. Poor ECOG performance status (≥2) was significantly associated with unfavorable induction outcomes in both univariate (OR = 4.58, 95% CI: 1.74 - 12.08, P = 0.002) and multivariate analyses (OR = 3.96, 95% CI: 1.39 - 11.27, P = 0.010). Severe thrombocytopenia (<50 ×10³/μL) and higher peripheral blood blast burden were also associated with poorer induction outcomes on univariate analysis. Patients with comorbidities demonstrated lower CR rates compared with patients without comorbidities, although this association did not reach statistical significance. Hypovolemic/hemorrhagic shock and sepsis were the leading causes of IID.</p><p><strong>Conclusions: </strong>Day-28 induction outcomes in AML patients from this resource-limited setting were strongly influenced by baseline functional status and disease burden. Poor ECOG performance status was the strongest independent predictor of unfavorable induction outcome. The findings highlight the importance of early risk stratification, optimized supportive care, and individualized induction strategies to improve AML outcomes in low-resource healthcare environments.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1117-1130"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal Natural Orifice Transluminal Endoscopic Ovarian Cystectomy versus Laparoscopic Ovarian Cystectomy. A prospective quasi-randomized pilot study.","authors":"Ahmed Hesham Abdel Hakim, Gasser Mohamed El Bishry, Omar Gamal Farag Mustafa, Ahmed Mohamed Essam, Ahmed Mohamed Abass, Osama Ismail Kamel","doi":"10.7417/CT.20262097","DOIUrl":"10.7417/CT.20262097","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive approaches have revolutionized the management of benign ovarian cysts, with laparoscopy long regarded as the gold standard. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging alternative offering the potential for scarless access and reduced postoperative discomfort. However, comparative data on pain outcomes between vNOTES and conventional laparoscopy for ovarian cystectomy remain lacking in the literature.</p><p><strong>Objective: </strong>To evaluate and compare postoperative pain scores, patient satisfaction, and surgical outcomes between vNOTES and conventional laparoscopic ovarian cystectomy.</p><p><strong>Methods: </strong>This prospective quasi-randomized pilot study included 20 premenopausal women undergoing ovarian cystectomy for benign pathology at a tertiary care center at Ain Shams University Maternity hospitals, Minimal Access surgery unit. Patients were equally divided into two groups: vNOTES (n = 10) and conventional laparoscopy (n = 10).</p><p><strong>Results: </strong>vNOTES was successfully completed in 80% of cases, with one conversion due to adhesions; laparoscopic completion rate was 90%. Operative time was shorter in the vNOTES group (85.6 ± 38.4 min) versus the laparoscopy group (103.7 ± 31.6 min), though not statistically significant (p = 0.26). Pain scores at 6 and 24 hours were lower in the vNOTES group (VAS: 6.0 and 3.0) compared to laparoscopy (VAS: 6.7 and 3.7), and patient satisfaction was significantly higher with vNOTES.</p><p><strong>Conclusions: </strong>vNOTES ovarian cystectomy is a safe, feasible technique associated with reduced early postoperative pain and improved patient satisfaction compared to conventional laparoscopy. These findings support the potential of vNOTES as a patient-centered surgical alternative and warrant further investigation in larger trials.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1001-1008"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Subtraction Angiography of the Prostatic Artery in Vietnamese Men: Anatomical Variants and Collateral Pathways. A Prospective Observational Study.","authors":"Hoang Giang Phan, Trung Dung Nghiem, Dang Luu Vu","doi":"10.7417/CT.2026.2111","DOIUrl":"10.7417/CT.2026.2111","url":null,"abstract":"<p><strong>Objective: </strong>To describe the origin, morphology, and branching patterns of the prostatic artery in Vietnamese men with symptomatic benign prostatic hyperplasia and to identify anatomical features relevant to planning and safety of prostatic artery embolization (PAE).</p><p><strong>Methods: </strong>This prospective study enrolled 120 patients who underwent pelvic digital subtraction angiography before planned PAE at Bach Mai Hospital, Hanoi, Vietnam between September 2022 and December 2024. For each hemipelvis, the number and origin of prostatic arteries were classified using the Yamaki and Moreira de Assis systems. Arterial diameter, length, tortuosity, atherosclerotic changes, and anastomotic connections with adjacent pelvic vessels were documented. Side-to-side differences were analyzed using paired tests, and correlations between arterial measurements and clinical variables were assessed.</p><p><strong>Results: </strong>A total of 240 hemipelves were evaluated. Yamaki type A was the predominant internal iliac artery branching pattern (77.9%). The most common prostatic artery origin was Moreira de Assis type I (46.7%), followed by types IV and III. A single prostatic artery was identified in 91.3% of hemipelves. Mean arterial diameter and length were 1.90 ± 0.43 mm and 180.53 ± 68.60 mm. Tortuosity was present in 70.4% of arteries, atherosclerosis in 38.3%, and anastomoses in 49.2%. No significant side-to-side differences were found in arterial diameter or tortuosity, whereas atherosclerosis differed (p = 0.040). Prostate volume showed a weak positive correlation with arterial diameter (r = 0.27; p < 0.05).</p><p><strong>Conclusions: </strong>Variability in prostatic artery anatomy highlights the importance of detailed vascular assessment for safe PAE.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1104-1110"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of conventional and micro-surgical techniques for gingival recession using collagen matrix: Randomised controlled split-mouth clinical trial.","authors":"Yeshwanth Perambudhuru, Lata Goyal, Mehak Gupta, Apurba Patra, Anika Dawar","doi":"10.7417/CT.2026.2096","DOIUrl":"10.7417/CT.2026.2096","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to determine the effectiveness of the microsurgical approach in treating gingival recession with collagen matrix by comparing it with Conventional surgery in terms of clinical and patient-centered outcomes.</p><p><strong>Methods: </strong>A total of 29 patients with bilateral gingival recession in the maxillary canine and/or premolar region were selected. After randomisation, bilateral recession sites were grouped into the test group (Microsurgery under 3.5 X magnification) and the control group (Conventional surgery). All the clinical and patient-reported parameters were recorded at baseline, 1, 3 and 6 months.</p><p><strong>Results: </strong>Both groups showed statistically significant differences in terms of reduction in gingival recession height (GRH), gingival recession width (GRW), clinical attachment level gain (CAL gain), increase in keratinized tissue thickness (KTT) and keratinized tissue width (KTW) after 6 months. But intergroup comparison showed no significant difference in terms of clinical parameters. The only significant difference was noted in terms of patient-centred parameters (Patient satisfactory score, Hypersensitivity score, Root aesthetic scores), which favoured the microsurgical group.</p><p><strong>Conclusions: </strong>Both groups demonstrated comparable clinical improvement; However, Patient-centred parameters were significantly better with the Microsurgical approach. Selection of the surgical approach should balance patient needs with practical considerations like cost, time, and clinician proficiency.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"992-1000"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifaceted Temozolomide Toxicity in Glioma: Detection & Care.","authors":"Ipsita Panda, M S Athiyamaan, Poovizhi Bharathi R, Manaal Shamsudeen","doi":"10.7417/CT.2026.20105","DOIUrl":"10.7417/CT.2026.20105","url":null,"abstract":"<p><strong>Background: </strong>Gliomas are the most common malignant primary brain tumors, and Temozolomide (TMZ) remains a key component of their management. Despite its efficacy, TMZ is associated with adverse drug reactions (ADRs) that may affect quality of life and treatment compliance. This study evaluated the pattern and frequency of ADRs in South Indian glioma patients receiving TMZ, examined demographic associations, and reviewed management strategies.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at KMC Hospital, Mangalore, India, over the past three years. Thirty-eight patients with histologically confirmed glioma who received oral TMZ were included. Data on demographics, tumor characteristics, treatment schedules, hematological and non-hematological ADRs, management approaches, and outcomes were extracted from medical records and analyzed using SPSS.</p><p><strong>Results: </strong>The study population was predominantly male (68.4%), with a median age of 45.5 years. Grade 3 and Grade 4 gliomas accounted for 31.6% and 34.2% of cases, respectively. A total of 38 ADRs were documented. The most frequent ADRs were leukocytopenia (9.3%) and itching (9.3%). Management strategies included treatment deferral, dose reduction, antihistamines, nonsteroidal anti-inflammatory drugs, and blood transfusions. Most ADRs resolved without hospitalization. Skin-related reactions typically subsided within 4-14 days, whereas hematological toxicities such as neutropenia required longer recovery periods (22-75 days). The mortality rate was low (5.3%), suggesting effective ADR management.</p><p><strong>Conclusion: </strong>TMZ-related ADRs in glioma patients are diverse, underscoring the need for vigilant monitoring of both hematological and non-hematological toxicities. Individualized management and careful tracking of recovery times can improve treatment tolerance and patient quality of life.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1058-1066"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Prolene Mesh Alone for Reconstruction After Moderate Chest Wall Resection: A Retrospective Observational Study.","authors":"Ahmed Mohamed, Mohamed Elghanam, Hossam Elsayed, Ahmed El Desouky, Hatem M Aboalazayem, Abdallah Mahmoud, Mohamed Sharaf Elfeky, Galal Farrag, Gamil K Ibrahim, Anas A Sayegh, Alaa Hamed Hakami, Mai Mosad Morsy, Ahmad Nagy Muhammad, Mohammed A Alharbi, Khaled Elsayed","doi":"10.7417/CT.2026.2110","DOIUrl":"10.7417/CT.2026.2110","url":null,"abstract":"<p><strong>Background: </strong>Moderate defects of the chest wall resulting from surgery for cancer require reconstruction in order to reestablish stability of the thorax. A flexible alternative to rigid prosthetics can be offered by polypropylene mesh; however, there are limited standardized outcome data available.</p><p><strong>Methods: </strong>The study was retrospective in nature and included 23 consecutive patients who underwent reconstruction with Prolene mesh due to moderate defects (greater than 5 cm or greater than 3 ribs) at four tertiary care centers between 2023 and 2025. The main outcomes measured were postoperative complications and pulmonary failure. The secondary outcomes measured were the length of drain placement and the length of hospital stay.</p><p><strong>Results: </strong>The cohort consisted of 23 individuals with a mean age of 41.4 (±20.5) years and a median defect size of 12 cm × 10 cm. No patient developed paradoxical motion, pulmonary failure, or infection related to the mesh. The overall morbidity rate was 39.1% (9/23), and all complications reported were classified as Clavien-Dindo grade I or II and included superficial wound infection (17.4%), atelectasis (17.4%), and seromas (13.0%). The median duration of ICU stay was 1 day (IQR: 1-1), the median duration of chest tube placement was 3 days (IQR: 2-3), and the median duration of hospital stay was 7 days (IQR: 7-8). Spearman's rank correlation analysis demonstrated a significant positive correlation between defect surface area and total hospital stay (rho = 0.67, p = 0.001). Patients with comorbidities had significantly longer hospital stays (median 9 vs. 7 days; p = 0.012) and Redivac drain durations (median 6 vs. 5 days; p = 0.016) compared to those without comorbidities.</p><p><strong>Conclusion: </strong>Prolene mesh alone is safe and technically feasible for moderate chest wall reconstruction, with no mechanical failures, low minor morbidity, and rapid postoperative recovery. Its use can be confidently considered as a first-line approach when appropriate mesh tensioning and viable soft tissue coverage are achieved, offering reassurance in surgical decision-making.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1096-1103"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}